Correlation of gallbladder wall pathology with controlled attenuation parameter, liver stiffness measurement, and laboratory markers in acute viral hepatitis A.

BACKGROUND

Acute viral hepatitis A remains a significant public health concern.

OBJECTIVE

This study investigated the relationship between gallbladder wall pathology, liver stiffness measurements, controlled attenuation parameter, and biochemical markers in adult patients with acute viral hepatitis A.

METHODS

Overall, 42 patients with acute viral hepatitis A were studied over 3 months. Patients underwent ultrasound and transient elastography examinations. Gallbladder wall thickness was categorised into two groups: 3-10 mm (group A) and ⩾10 mm (group B).

RESULTS

Gallbladder wall thickening was detected in 95% of patients. Stratification and fluid accumulation were present in 71% and 38% of patients, respectively. Gallbladder wall thickness ⩾10mm was significantly associated with stratification and fluid accumulation (p < 0.0001). Higher gallbladder wall thickness correlated with elevated alanine aminotransferase (p = 0.008), ammonia levels (p = 0.011), and international normalised ratio (p = 0.047). A positive correlation was observed between procalcitonin levels ⩾0.25 ng/mL and gallbladder wall thickness ⩾10 mm (p = 0.011). The controlled attenuation parameter values were significantly lower in patients with greater gallbladder wall thickness (p = 0.013), while liver stiffness measurement showed no correlation with gallbladder wall thickness.

CONCLUSION

In acute viral hepatitis A, gallbladder wall thickening is almost a pathognomonic finding. Increased gallbladder wall thickness correlates with increased alanine aminotransferase, ammonia, international normalised ratio, and procalcitonin levels, highlighting its potential as a non-invasive marker of disease severity. Controlled attenuation parameter and liver stiffness measurement require cautious interpretation in acute inflammation. These findings support gallbladder wall assessment as a valuable tool in evaluating acute viral hepatitis A.